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Copyright of Revista de Gastroenterología del Perú is the property of Sociedad de Gastroenterologia del Peru and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Eliminating viral hepatitis became a global goal and was targeted by countries worldwide. Using WHO, Google Scholar, PubMed, and other databases, the progress of Central Asian countries (Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan) in ending viral hepatitis B and C by 2030 was evaluated and reported. Collected data shows that countries have made significant efforts toward achieving goals in the Global Health Sector Strategy. All countries have national programs focused on hepatitis elimination and have reached the target vaccination coverage against hepatitis B. However, the available information requires regular updates, and public accessibility of data collected by governments should be enhanced. Additionally, countries are recommended to improve harm reduction and treatment services. [ABSTRACT FROM AUTHOR]

Background: In the Americas, the Pan American Health Organization (PAHO) has promoted initiatives that aim at the elimination of mother-to-child transmitted diseases for over two decades. Although Guatemala has assumed the commitment to improve access and coverage of reproductive and perinatal services, the goals have not yet been reached. Often, the implementation of these efforts is hampered by complexities rooted in social, cultural, and environmental intersections. The objective of this work is to share our experience applying gender intersectionality as a methodological and analytical tool in a participatory research project that aims to improve access to maternal and child health screening services. The study shows the novel strategy that incorporates intersectionality contributing to evidence on how it can be applied to strengthen public health efforts around the implementation of the EMTCT Plus (Elimination of mother-to-child transmission of HIV, Syphilis, Hepatitis B, and Chagas disease) framework, in the mostly rural municipality of Comapa, in Guatemala. Methods: We applied a participatory methodology, integrating theoretical and methodological frameworks to have an intersectional understanding of health services delivered by both, midwives, and the public health institution, for the prevention, diagnosis, treatment, and follow-up of HIV, Syphilis, Hepatitis B, and Chagas. The data was collected by conducting interviews, focus groups, workshops, and reviewing laboratory databases, guided by five strategies from a cultural appropriateness framework. Results: The intersectional analysis shed light on the synergies and gaps of the current efforts and protocols implemented by both the midwives and the Ministry of Health. The services offered for the four diseases were often delivered independently from each other, and a comprehensive educational and communication material strategy was absent. However, our findings will be used to inform consistent, locally relevant, and culturally appropriate educational content for the local population, also following the national policy guidelines. Conclusions: Using intersectionality as a method and as an analytical tool allowed us to understand the (1) interrelation of diverse social, cultural, and environmental determinants which influence the delivery of health services, as well as (2) the dynamics between the traditional and institutional health systems. (3) Community engagement and the participation of different stakeholders in a consultative process have been fundamental for the conceptual and methodological tenets of this research. (4) Finally, giving a more prominent role to midwives can strengthen sustainability and cultural appropriateness, which is complementary to the delivery of institutional health services. [ABSTRACT FROM AUTHOR]

The achievement of a functional cure for chronic hepatitis B (CHB) remains limited to a minority of patients treated with currently approved drugs. The primary objective in developing new anti-HBV drugs is to enhance the functional cure rates for CHB. A critical prerequisite for the functional cure of CHB is a substantial reduction, or even eradication of covalently closed circular DNA (cccDNA). Within this context, the changes in cccDNA levels during treatment become as a pivotal concern. We have previously analyzed the factors influencing cccDNA dynamics and introduced a preliminary classification of hepatitis B treatment strategies based on these dynamics. In this review, we employ a systems thinking perspective to elucidate the fundamental aspects of the HBV replication cycle and to rationalize the classification of treatment strategies according to their impact on the dynamic equilibrium of cccDNA. Building upon this foundation, we categorize current anti-HBV strategies into two distinct groups and advocate for their combined use to significantly reduce cccDNA levels within a well-defined timeframe. [ABSTRACT FROM AUTHOR]

Objective • To investigate the long-term safety and efficacy of autologous peripheral blood stem cell transplantation (APBSCT) in treating decompensated hepatitis B cirrhosis. Methods • In this study, a retrospective analysis was conducted on a cohort of 84 patients diagnosed with decompensated hepatitis B cirrhosis between January 2011 and December 2012. The patients were categorized into two groups based on their treatment approach: the transplantation group, consisting of 34 cases who received APBSCT in addition to medical treatment, and the comprehensive medical treatment (CMT) group, comprising 50 cases who solely received CMT. EPI Data software was used for data input and verification. Survival curves were drawn by Kaplan-Meier method and analyzed by log-rank test. Paired t test and independent sample t test were used for intra-group and inter-group mean comparison of measurement data, respectively. The Mann- Whitney U test is used for non-normally distributed data. Results • After the ten-year follow-up period, it was found that overall survival (OS) in the transplantation group was markedly higher than that in the CMT (56% vs. 16%, P < .001). Albumin (ALB), prothrombin time (PT), and indocyanine green retention at 15 min (ICG R15) were significantly improved in sequence at 4 to 12 weeks of early treatment in APBSCT group; subsequently, the Acoustic radiation force impulse (ARFI) index and spleen length significantly decreased at 48 weeks. Compared with the CMT group, ALB and PT levels in the APBSCT group continued to recover and eventually stabilize at normal or low-risk levels at subsequent follow-ups up to 8 years. The ten-year prevalence of hepatocellular carcinoma (HCC) in the APBSCT group was markedly lower than that in the CMT group (26% vs. 62%; P = .025). Moreover, APBSCT significantly reduced ascites (χ² = 6.997, P = .041) and was not associated with any significant adverse events during APBSCT. Based on clinical evidence, APBSCT is a safe and effective treatment for decompensated hepatitis B cirrhosis, resulting in a favorable long-term prognosis with no significant adverse events. Conclusions • APBSCT is a relatively safe and effective treatment for decompensated hepatitis B cirrhosis. [ABSTRACT FROM AUTHOR]

There are 82 million people living with hepatitis B (PLWHB) in the World Health Organization Africa region, where it is the main cause of liver disease. Effective vaccines have been available for over 40 years, yet there are 990,000 new infections annually, due to limited implementation of hepatitis B birth dose vaccination and antenatal tenofovir prophylaxis for highly viraemic women, which could eliminate mother-to-child transmission. Despite effective and cheap antiviral treatment which can suppress hepatitis B virus replication and reduce the risk of hepatocellular carcinoma (HCC), < 2% of PLWHB are diagnosed, and only 0.1% are treated. As a result, PLWHB are frequently diagnosed only when they have already developed decompensated cirrhosis and late-stage HCC, and consequently 80,000 hepatitis B-associated deaths occur each year. Major barriers include complex treatment guidelines which were derived from high-income settings, lack of affordable diagnostics, lack or insufficient domestic funding for hepatitis care, and limited healthcare infrastructure. Current treatment criteria may overlook patients at risk of cirrhosis and HCC. Therefore, expanded and simplified treatment criteria are needed. We advocate for decentralized community treatment programmes, adapted for low-resource and rural settings with limited laboratory infrastructure. We propose a strategy of treat-all except patients fulfilling criteria that suggest low risk of disease progression. Expanded treatment represents a financial challenge requiring concerted action from policy makers, industry, and international donor agencies. It is crucial to accelerate hepatitis B elimination plans, integrate hepatitis B care into existing healthcare programmes, and prioritize longitudinal and implementation research to improve care for PLWHB. [ABSTRACT FROM AUTHOR]

Aim: The equilibrium between the host immune response counter the hepatitis B virus (HBV) and the amount of viral replication is a crucial factor in the pathogenesis of HBVassociated liver disease. Tumor necrosis factor-alpha (TNF-a) is a considerable proinflammatory and immune regulatory cytokine in the pathogenesis of various inflammatory and autoimmune conditions. There is no consensus on using antiviral prophylaxis treatments in cases who have been exposed to hepatitis B but have not become chronically ill, and are thus planned to receive anti-TNF-a treatment. The aim of this study is to determine the frequency of reactivation after anti-TNF treatment in cases with isolated anti-HBc total positivity who have been exposed to hepatitis B virus. Materials and Methods: Serological HBV infection markers (HBsAg, anti-HBc IgG and anti-HBs) of 1467 adult cases who received anti-TNF therapy for the indications of various rheumatological diseases in the rheumatology and physical therapy clinics between the years 2010-2021 were retrospectively screened using the hospital's electronic information system. Results: 140 rheumatologic disease cases who took a TNF-a inhibitor (infliximab, adalimumab, etanercept, golimumab, certolizumab) treatment were included in this study. Before the cases were started on TNF-a treatment, all cases were anti-HBc total positive, 110 were anti-HBs positive, 30 were anti-HBs negative, and 4 were HbsAg positive and HBV-DNA negative. The median pre-treatment anti-HBc total and anti-HBs values of the cases were 5.6 IU/L and 79.29 IU/L, respectively. No HBV reactivation was observed in any of the 140 cases after a median follow-up duration of 71.5 (min. 8, max. 185) months. Conclusion: In conclusion, HBV reactivation was not detected in any of the anti-HBc positive cases included in this study, which suggest that anti-HBc positive cases can be followed up with close follow-up without starting them on anti-TNF therapies and antiviral prophylaxis. [ABSTRACT FROM AUTHOR]

Copyright of ESTUDAM Public Health Journal is the property of ESTUDAM Public Health Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim of the study: To analyze the hepatitis B virus (HBV) infection and mortality in Poland according to sociodemographic characteristics, trends over time, and the impact of the COVID-19 pandemic on hepatitis B epidemiology. Material and methods: We examined HBV infection cases and deaths reported by national registries and used Joinpoint analysis to estimate time trends in the years 2005-2021. To assess the impact of the COVID-19 pandemic on HBV infection, we used monthly information and compared 2020-2022 with 2019. Results: The Joinpoint analysis showed that in Poland between 2005 and 2021, there were pronounced decreasing trends of acute HBV infection, and during the pandemic period, acute HBV infection dramatically decreased (annual percent change, APC2019-2021 for men -57.65%, and women -42.10%, both ptrend < 0.05). There was a fluctuation in trends for chronic HBV infection, shifting from positive to negative in both genders in 2016, and over the pandemic, there were decreasing trends (APC2019-2021 for men -26.94% and women -28.96%, both ptrend < 0.05). From March to July 2022, the value of the diagnosis rate of HBV infection was lower compared to the respective months in 2019, but from September to December 2022, the rate changes were positive. Mortality due to HBV infection decreased in both genders, mainly within the 2005-2019 period. Conclusions: During the COVID-19 pandemic, a sharp decrease in HBV diagnosis rates in Poland, especially in acute cases, was observed. However, trends of hepatitis B infection require further monitoring. It is necessary to introduce a national screening program that also encompasses the population of migrants and improve the linkage to care. [ABSTRACT FROM AUTHOR]

We aimed to study the virologic profile of immigrants from Africa with viral hepatitis-related hepatocellular carcinoma (HCC) who received care at our institution. We conducted a descriptive study among African-born patients with HCC who received care at University of Minnesota Medical Center from 2011 to 2018. We analyzed the prevalence, virologic profiles and treatment of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections prior to HCC diagnosis. 74 African-born patients with HCC were eligible for analysis. 54 had HCV and 20 had HBV infection. 80% of HBV patients were treated but remained with inadequate viral suppression at the time of HCC diagnosis while only 39% of HCV patients were treated prior to HCC diagnosis. Lost to follow up was common in both groups. Our findings suggest that there is a significant gap in appropriate viral hepatitis care in an African immigrant population in Minnesota. Culturally-appropriate strategies are needed to bridge this gap. [ABSTRACT FROM AUTHOR]

Background: Concomitant bacterial pathogens associated with hepatitis B infection could further increase the stress on the liver of infected individuals thereby complicating the infection. Objective: This necessitates the need to evaluate the antibacterial activity of Citrus aurantium L. leaf extracts on bacteria isolated from blood of hepatitis B virus (HBV) positive individuals in Ondo State, Nigeria. Method: The leaf extracts of Citrus aurantium (aqueous, ethanol and N-hexane) were assessed for possible antibacterial activities against some isolated bacteria from blood samples of HBV positive individuals were conducted using agar well diffusion technique. Results: Proteus mirabilis, S. typhi, S. aureus, Kl. pneumoniae, Ps. aeruginosa, E. coli, S. pneumoniae and Ch. Violaceum were isolated. The most frequently encountered bacterial species was S. aureus (52%). The ethanol leaf extract exerted the highest growth inhibitory activity on S. aureus, Kl. pneumoniae, Ps. auruginosa and E. coli. The aqueous leaf extract exerted the highest inhibitory on Ch. violaceum while the N-hexane extract exerted the highest growth inhibitory activity on P. mirabilis and Ps. aeruginosa. The extracts compared favorably well with conventional antibiotic (Ciprofloxacin) which is the positive control. The minimal inhibitory concentration (MIC) of all the extracts ranged from 12.5 to 50.0 mg/ml while the minimal bactericidal concentration (MBC) ranged from 25 to 100mg/ml. The analysis of the phytochemicals revealed the presence of tannins, flavonoids, terpenoids, steroids, cardiac glycoside and saponin in all the leaf extracts except for the absence of saponins in N-hexane extract. Conclusion: This study showed that these extracts could be exploited to treat infection caused by these bacterial pathogens. [ABSTRACT FROM AUTHOR]

Background Clinical management of chronic hepatitis B virus (HBV) infection is complex and access to antiviral treatment remains limited in sub-Saharan Africa. International guidelines recommend monitoring at least annually for disease progression among HBV-infected people not meeting treatment criteria at initial diagnosis. This study aimed to assess the impact and cost-effectiveness of alternative strategies for monitoring. Methods We used a mathematical model of HBV transmission and natural history, calibrated to all available West African data, to project the population-level health impact, costs and cost-effectiveness of different monitoring strategies for HBV-infected individuals not initially eligible for antiviral treatment. We assumed that these patients were found in the year 2020 in a hypothetical community-based screening programme in The Gambia. Monitoring frequencies were varied between every 5 and every 1 year and targeted different age groups. Results The currently recommended annual monitoring frequency was likely to be not cost-effective in comparison with other strategies in this setting. 5-yearly monitoring in 15-45-year olds, at US$338 per disability-adjusted life year averted, had the highest probability of being the most effective cost-effective monitoring strategy. Conclusions Monitoring less frequently than once a year is a cost-effective strategy in a community-based HBV screening and treatment programme in The Gambia, with the optimal strategy depending on the cost-effectiveness threshold. Efficiencies may be gained by prioritising the 15-45-year age group for more intensive monitoring. [ABSTRACT FROM AUTHOR]

330 Background: Patients with a history of HBV exposure are at risk of reactivation when receiving treatments that affect the immune system, such as cancer-directed therapies. ASCO guidelines recommend universal HBV screening prior to initiation of cancer-directed therapies to prevent hepatic dysfunction and delays in cancer care. However, significant variation remains in clinical practice. Improving HBV screening is of special interest at our institution, given that we serve a large proportion of Asian immigrants at high risk of prior HBV exposure. With our institution's transition to EPIC on Apr 1, 2022, the HBV serology order set was incorporated into the pre-treatment checklist of every cancer therapy plan. We studied the rates of HBV screening before and after implementing this change. Methods: We identified patients with cancer starting systemic cancer treatment at our institution between Oct 1, 2021 – Mar 31, 2022 (pre-EPIC period), and Oct 1, 2023 – Mar 31, 2023 (post-EPIC period). Patients who received only endocrine therapy, transferred care, or lost to follow-up prior to treatment initiation were excluded. To select a random sample from each time-period of interest, patients were assigned a random number, sorted based on this random number, and then reviewed in order. All data was collected retrospectively by manual chart review. Results: We randomly selected and reviewed 69 patients from pre-EPIC period, and 75 from post-EPIC period. Their demographic, disease, and treatment characteristics are summarized in the table. HBV screening rates were 42% and 80% in the pre-and post-EPIC periods, respectively (p<0.001). Twenty-one (14.6%) patients screened positive for HBV core antibody, among whom six (5.1%) had negative surface antibodies. Conclusions: The built-in HBV serology order set significantly improved rates of hepatitis B screening prior to starting systemic cancer-directed treatment. It is a low-cost and highly effective intervention. Our next steps are to determine how a higher adherence to HBV screening guidelines impacted the management of patients with prior HBV exposure. Pre-EPIC: Oct 1, 2021 - Mar 31, 2022 (N=69) Post-EPIC: Oct 1, 2022 – Mar 31, 2023 (N=75) P values Age at diagnosis (years), mean (SD) 62.1 (1.4) 65.2 (1.6) 0.15 Female (%) 40 (58.0) 35 (46.7) 0.18 Race (%): 0.051 White 51 (73.9) 49 (65.3) Asian 8 (11.6) 20 (26.7) Other 10 (14.5) 6 (8.0) Cancer type (%): 0.39 Hematological Malignancies 19 (27.5) 16 (21.3) Solid Tumor 50 (72.7) 59 (78.7) Metastatic Disease (%) 24 (34.8) 25 (33.3) 0.95 Treatment Type (%): 0.13 CD20 mAb +/- other 3 (4.4) 9 (12.0) Chemotherapy +/-other 52 (75.4) 57 (76.0) Other 14 (20.3) 9 (12.0) mAb: monoclonal antibody. [ABSTRACT FROM AUTHOR]

Background: To promote general health in patients with hepatitis, it is vital to develop effective interventions to improve the lifestyle of these patients. The present study aimed to investigate the effectiveness of group cognitive-behavioral therapy (CBT) on the lifestyle of patients with hepatitis B. Methods: This was a quasi-experimental study with a pre-test-post-test and control group design. A sample of patients with chronic hepatitis B was selected from all patients visiting specialized clinics in Tehran, Iran in 2021. Thirty patients with hepatitis B were selected and randomly allocated to two experimental and control groups (15 patients per group). Eight sessions of group CBT (one 90-minute session per week for two months) were performed, and the Post-test was then administered to both groups. The data were collected by the health promoting lifestyle profile-II (HPLP-II) scale and analyzed via the analysis of covariance (ANCOVA) and t-test using SPSS software, version 26. Results: There was no significant difference between the lifestyle mean scores of the groups in the pre-test stage. The Mean±SD post-test scores of the experimental and control groups were 133.42±6.28 and 94.76±5.68, respectively (P<0.001). The group CBT increased health-promoting lifestyle indicators, including health responsibility (P=0.029), physical activity (P=0.050), nutrition (P=0.045), spiritual growth (P=0.045), interpersonal relations (P=0.002), and stress management (P=0.001) in patients with hepatitis B. Conclusion: The findings indicated the effectiveness of group CBT in improving the health-promoting lifestyle of patients with hepatitis B. CBT can thus be used by clinical psychologists and psychiatric nurses to promote a healthy lifestyle in these patients. [ABSTRACT FROM AUTHOR]

Background: Chronic hepatitis B (CHB) infection remains a significant public health issue for Indigenous Australians, in particular for remote communities. Aim: To evaluate the spectrum of hepatitis B virus (HBV) care provided to a remote Aboriginal community. Measures studied included screening, seroprevalence, vaccination rates and efficacy, and HCC risk and surveillance adherence. Methods: A retrospective audit of HBV care received by all permanent residents currently attending a remote Aboriginal Health service. This study was endorsed by both the local Aboriginal Health service and the Aboriginal Health Council of South Australia. Results: A total of 208 patients attended the clinic, of whom 52% (109) were screened for HBV. Of these, 12% (13) had CHB and 20% (22) had evidence of past infection. Similarly, of the 208 attending patients, complete vaccination was documented in 48% (99). Of the 33 patients with post‐vaccination serology, 24% (8) had subtherapeutic (<10 IU/mL) levels of HBsAb. Subtherapeutic HBsAb was independently associated with higher Charlson Comorbidity scores (odds ratio = 17.1; 95% confidence interval 1.2–243.3; P = 0.036). Definitive breakthrough infection was identified in 6% (2) patients. One HBsAg positive patient was identified as needing HCC surveillance, but had not undertaken HCC surveillance. Conclusion: Opportunities to improve the quality of CHB care through increased HBV vaccination, screening and adherence to HCC surveillance were identified. High rates of subtherapeutic vaccine responses and documented breakthrough infection raises concerns about the effectiveness of current CHB vaccines in this population. [ABSTRACT FROM AUTHOR]

Chronic hepatitis B is a critical cause of many serious liver diseases such as hepatocellular carcinoma (HCC). The main challenges in hepatitis B treatment include the rebound of hepatitis B virus (HBV)-related antigen levels after drug withdrawal and the immunosuppression caused by the virus. Herein, we demonstrate that the HBV-related antigen can be effectively inhibited and antiviral immunity can be successfully reactivated through codelivery of the small interfering RNA (siRNA) targeting HBV X protein (HBx) and the plasmid encoding interleukin 12 (pIL-12) to hepatocytes and immune cells. After being treated by the siRNA/pIL-12 codelivery system, HBx mRNA and hepatitis B surface antigen (HBsAg) are dramatically reduced in HepG2.215 cells. More importantly, the downregulated CD47 and programmed death ligand 1 (PD-L1) and the upregulated interferon-β promoter stimulator-1 (IPS-1), retinoic acid-inducible gene-1 (RIG-1), CD80, and human leukocyte antigen-1 (HLA-1) in treated HepG2.215 cells indicate that the immunosuppression is reversed by the codelivery system. Furthermore, the codelivery system results in inhibition of extracellular regulated protein kinases (ERK) and phosphoinositide-3-kinase (PI3K)/protein kinase B (Akt) pathways, as well as downregulation of B-cell lymphoma-2 (Bcl-2) and upregulation of p53, implying its potential in preventing the progression of HBV-induced HCC. In addition, J774A.1 macrophages treated by the codelivery system were successfully differentiated into the M1 phenotype and expressed enhanced cytokines with anti-hepatitis B effects such as interleukin 6 (IL-6) and tumor necrosis factor-α (TNF-α). Therefore, we believe that codelivery of siRNA and pIL-12 can effectively inhibit hepatitis B virus, reverse virus-induced immunosuppression, reactivate antiviral immunity, and hinder the progression of HBV-induced hepatocellular carcinoma. This investigation provides a promising approach for the synergistic treatment of HBV infection. [ABSTRACT FROM AUTHOR]

The article focuses on the U.S. Food and Drug Administration's updated label indication for Vemlidy 25 milligram, now approved for treating chronic hepatitis B in children aged six years and older weighing at least 25 kilogram. Topics include the drug's previous approvals, the significance of treating hepatitis B in children, and the results of a phase 2 clinical trial demonstrating the drug's efficacy in young patients.

Objectives: To find out the effects and prevalence of disease-modifying antirheumatic drugs (DMARDs) and anti-TNF agents on hepatitis B virus (HBV) reactivation in hepatitis B surface antigen (HBsAg)-positive patients with rheumatic diseases (RD). Methods: This retrospective study was conducted on 1,548 RD patients. Patients' medical records regarding immunological profiles, clinical courses, and outcomes, were obtained. In this research, the patient used conventional DMARDs (cDMARDs) and biological DMARDs (bDMARDs). A drug exposure was considered when a patient was administered GC, cDMARDs, or bDMARDs for > 4 weeks. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and bilirubin were measured. HBsAg, HBV DNA assay, anti-HCV and HIV were identified. Results: HBsAg was positive in 19 (37.3%) patients. Anti-HBs in 5 (9.8%) patients and anti-HBc IgG in 35 (68.6%) patients were positive. All patients with HBsAg positivity were receiving antiviral prophylaxis. Anti-HCV was positive in 25.5% (n = 13) of individuals . There was not any reactivation among the patients. No HBV reactivation was observed. Conclusions: Screening before treatment and give prophylaxis to patients who have occult hepatitis or hepatitis B, may be an important factor in the absence of reactivation. Hepatitis screening should be performed in all patients prior to biological treatment is initiated. [ABSTRACT FROM AUTHOR]

This article uses the real medical records and web pages of Chinese medicine diagnosis and treatment of hepatitis B to extract structured medical knowledge, and obtains a total of 8,563 entities, 96,896 relationships, 32 entity types, and 40 relationship types. The structured data was stored in the Neo4j graph structure database, and a knowledge graph of Chinese medical diagnosis and treatment of hepatitis B was constructed. The knowledge map is used as a structured data source to provide high-quality knowledge information for the medical question and answer system based on hepatitis B disease. Applying the deep learning method to the question identification and knowledge response of the question answering system makes the hepatitis B medical intelligent question answering system has important research and application significance. The question-and-answer system takes aim at hepatitis B, a public health problem in the world and leverages the advantages of traditional Chinese medicine for diagnosis and treatment. It provides a reference for doctors' disease diagnosis, treatment, and patient self-care. Its value is important for the treatment of hepatitis B disease. [ABSTRACT FROM AUTHOR]

There is established literature on health workers' attitudes towards working with people living with stigmatised health conditions and behaviours, such as HIV, hepatitis C and injecting drug use. Less is known about health workers' attitudes and concerns around providing care to people living with hepatitis B virus (HBV), which is concerning as research indicates that negative attitudes may impact on the quality of care provided to these populations, with adverse health outcomes for clients. The aim of this paper is to examine health and medical workers' concerns about providing care to people living with HBV, and the factors that may influence these concerns. Australian health and medical workers (n = 551) completed an online survey measuring their concerns about providing care to people living with HBV, stigmatising attitudes towards this group, perceived comfort of themselves and colleagues in providing care towards clients with HBV, and witnessing their colleagues behaviour in a discriminatory way towards clients with HBV. Multiple regression was used to ascertain factors predictive of health workers' concerns about working with clients with HBV. Results showed that older participants and those who had spent less time working in the health and medical field had greater concerns about caring for people living with HBV. Workers who did not know someone living with HBV, who were less comfortable around clients with HBV, who perceived their colleagues to be less comfortable working with clients with HBV, and who had more negative attitudes towards this group also had greater concerns around providing care to people living with HBV. Efforts should be made to improve health and medical workers' attitudes towards working with people with HBV. This may also improve workers' level of comfort with people with HBV and reduce the reported reticence they have towards working with this client group. [ABSTRACT FROM AUTHOR]

Copyright of Acta Odontologica Turcica is the property of Acta Odontologica Turcica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Hepatitis B virus (HBV) infection remains a significant public health challenge, particularly for immunocompromised patients. Our aim was to evaluate the serologic immunity in immunocompromised rheumatology and inflammatory bowel disease (IBD) patients, assess factors for serologic nonimmunity, and evaluate their response to 1 HBV booster dose.Methods: Immunocompromised rheumatology and IBD patients with completed HBV screening were identified. A chart review was performed to collect demographics, clinical information, baseline HBV serology results, and serologic response to booster vaccination. Serologic nonimmunity was defined as a negative/indeterminate hepatitis B surface antibody (anti-HBs) level.Results: Among 580 patients, 71% were nonimmune. The highest portion of nonimmune patients were 11-18 years old (P = 0.004). There was no significant difference between immune and nonimmune patients with regards to diagnosis (P = 0.34), age at diagnosis (P = 0.64), duration of treatment (P = 0.07), or type of medications (P = 0.08). Sixty-two percent of those who received a booster vaccine were rescreened, and most (68%) seroconverted. In those 18 years or older, only half seroconverted.Conclusion: Results of this study support the benefit of HBV screening in immunosuppressed patients. Beginning at age 11 years, most patients lacked serologic immunity to HBV. Seroconversion for most patients 11-18 years occurred after 1 booster vaccine. Thus, for immunocompromised patients without recent HBV serologic data, obtaining the HBV serology beginning at age 11 years might be considered. Those 18 years and older were least likely to seroconvert after 1 booster, indicating that they may benefit from receiving the 3-dose HBV vaccine series. [ABSTRACT FROM AUTHOR]

Background and Objectives: Development of hepatitis-B is considered a serious complication after liver transplantation. HBV de novo infection is a rather rare phenomenon, however it deserves attention in the era of donor organ shortage. The aim of the present analysis was to examine its course in liver transplant patients. Materials and Methods: Prevalence of de novo HBV-infections was extracted from our local transplant data base. Analysis focused on the moment of HBV-detection and on the long-term follow-up in terms of biochemical and histological changes over 30 years. Results: 46 patients were identified with the diagnosis of de novo hepatitis B. Median time from liver transplantation to diagnosis was 397 days (7-5505). 39 patients received antiviral therapy. No fibrosis progression could be detected, whereas the grade of inflammation significantly lessened from the moment of HBV detection to the end of histological follow-up over a median of 4344 days (range 123-9490). Patients with a poor virological control demonstrated a significantly poorer overall survival. Conclusions: De novo hepatitis B in liver transplant patients is a condition that can be controlled very well without significant fibrosis progression or graft loss if recognized on time within a regular transplant follow-up schedule. [ABSTRACT FROM AUTHOR]

Background and Objectives: Hepatitis B virus infection remains a major public health concern. The interaction between hepatitis B virus (HBV) hepatitis B virus and the host inflammatory response is an important contributing factor driving liver damage and diseases outcomes. The management of chronic hepatitis B virus infection is an area of massive unmet clinical need worldwide. Our primary aim for this study was to evaluate biological response rates and sustained virological response in patients with chronic hepatitis B treated with Peg-IFN α-2a/b. The second aim of the study was the identification of metabolic changes and insulin resistance. Materials and Methods: We enrolled in this study 166 patients who fulfilled all inclusion and exclusion criteria. These treatment-naive patients with chronic HBV were treated with Pegylated Interferon α-2a/b. HBV infection was defined by the presence of HBV serological markers (HBsAg, anti-HBsAb, anti-HBcAb, HBeAg, anti HBeAb) by Enzyme-Linked Immuno Sorbent Assay (ELISA) and serum HBV-DNA levels were estimated by a commercially available quantitative polymerase chain reaction (PCR) assay. Results: Patients' recovery progress has been evaluated by determining the following: age, gender; biochemical tests; alanine aminotransferase, aspartate aminotransferase; serological assays for HBV serological markers (HBsAg, anti-HBsAc/Ab, anti-HBcAc/Ab, HBeAg, anti HBeAc/Ab); molecular tests to detect viral particles, testing for HBV DNA (PCR) to confirm the diagnosis and quantify the number of viral copies in the blood (viremia); liver ultrasound--performed through epigastric and intercostal approach (transversal and longitudinal sections). Conclusions: Our results indicated that only HOMA index values, that of fasting insulin, together with baseline HBV DNA, alanine aminotransferase values, mean blood glucose at the beginning of treatment may be predictive of the early viral response in chronic hepatitis B. [ABSTRACT FROM AUTHOR]

Background GLS4 is a first-in-class hepatitis B virus (HBV) capsid assembly modulator (class I) that can inhibit HBV replication by interfering with the assembly and disassembly of HBV nucleocapsid. Here, we evaluated its antiviral activity, pharmacokinetics, and tolerability in a double-blind, randomized, parallel, entecavir-controlled study. Methods Twenty-four patients with chronic HBV were randomized to receive a 28-day course of GLS4 (120 or 240 mg) and ritonavir (100 mg) combination (cohorts A and B, respectively) or entecavir treatment (cohort C) at a 1:1:1 ratio. Patients were followed up for 40 days in a phase 1b study. Results The GLS4/ritonavir combination was a tolerated combination for the treatment of chronic HBV infection. A total of 2, 3, and 3 subjects presented with alanine aminotransferase flare in cohorts A, B, and C, respectively. This contributed to the withdrawal of 1, 2, and 1 patient from cohorts A, B, and C, respectively. The mean Ctrough of GLS4 was 205–218 ng/mL, which was approximately 3.7–3.9 times the 90% effective concentration (55.8 ng/mL), with a lower accumulation (accumulation rate, 1.1–2.0). In cohorts A, B, and C, the mean declines in HBV DNA after 28 days of treatment were −1.42, −2.13, and −3.5 log10 IU/mL; in hepatitis B surface antigen were −0.06, −0.14, and −0.33 log10 IU/mL; in pregenomic RNA were −0.75, −1.78, and −0.96 log10 copies/mL; and in hepatitis B core antigen were −0.23, −0.5, and −0.44 log10 U/mL, respectively. Conclusions Treatment with 120 mg GLS4 was tolerated and had antiviral activity in patients with chronic HBV infection. Clinical Trials Registration Chinese Clinical Trial Registry; CTR20160068. http://www.chinadrugtrials.org.cn. [ABSTRACT FROM AUTHOR]

Introduction: Hepatitis B virus (HBV) infection remains a global public health threat, with approximately 257 million people suffering from chronic HBV infection worldwide in 2015. HBV reactivation is a known complication of immunosuppressive therapy in people suffering with chronic HBV. Medications commonly associated with HBV reactivation include B-cell depleting agents and anthracycline derivatives. There have been very few documented cases of chemoradiation inducing HBV reactivation among scientific literature. Case report: A 44-year-old woman with chronic HBV infection and [FIGO] stage IIIB cervical cancer developed marked transaminitis and increased HBV viral load after receiving treatment with three doses of cisplatin and one dose of carboplatin with concurrent radiation for cervical cancer. Management and outcome: The patient was admitted for acute liver failure and quickly developed encephalopathy, with treatment complicated by coagulopathy, hypoglycemia, and metabolic acidosis. The patient remained unresponsive to maximal therapeutic efforts and was mechanically ventilated for airway protection. She subsequently died after experiencing ventricular tachycardia followed by asystole. Discussion: There are currently no standardized guidelines for the screening of HBV infection or prophylaxis treatment algorithm for patients undergoing chemoradiation. When initiating treatment with immunosuppressive therapy, it is important to screen all patients for chronic HBV infection and to work with an interdisciplinary team of oncologists, hepatologists, and pharmacists to initiate prophylactic antiviral therapy and closely monitor to minimize the risk of HBV reactivation. [ABSTRACT FROM AUTHOR]

Objective: Data on the efficacy and duration of nucleos(t)ide analogue (NUC) therapies to prevent the development of cirrhosis and hepatocellular carcinoma in chronic hepatitis B (CHB) patients are scarce and heterogeneous. This study aimed to summarize the clinical and laboratory results of the patients with CHB infection who discontinued oral antiviral therapy. Methods: A single-centered cohort study was conducted with CHB infection. NUCs were discontinued in patients who were under viral suppression for at least two years with undetectable HBV DNA levels for 18 months. Risk factors for clinical relapse (CR) were evaluated. Results: A total of 77 patients were recruited. HBeAg status showed that 9.4% of the patients underwent HBeAg seroconversion with NUCs. HBeAg reversion was noted in four (31%) of these patients. Severe hepatitis, which resolved after antiviral therapy was restored, was reported in two out of 77 patients (4%). None of the patients with CR had clinical or biological signs of hepatic decompensation or died during the study period. Conclusions: We found no benefits of the discontinuation of antiviral therapy after viral suppression in patients with initially severe fibrotic HBV infection. In patients with mild to moderate fibrosis, cessation of antiviral treatment is not associated with adverse outcomes. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Entecavir (ETV) and tenofovir alafenamide (TAF) are both first-line hepatitis B virus (HBV) therapies, but ETV-to-TAF switch outcome data are limited. We aimed to assess outcomes up to 96 weeks after ETV-to-TAF switch. METHODS: ETV-treated (≥12 months) chronic hepatitisBpatients switched to TAF in routine practice at 15 centers (United States, Korea, Japan, and Taiwan) were included. Primary outcome was complete viral suppression (CVS) rate (HBV DNA <20 IU/mL). RESULTS: We analyzed 425 eligible patients (mean age 60.7613.2 years, 60% men, 90.8%Asian, 20.7% with diabetes, 27% with hypertension, 14.8% with cirrhosis, 8.3% with hepatocellular carcinoma, and mean ETV duration before switch 6.16 ± 3.17 years). The mean baseline estimated glomerular filtration rate (eGFR) was 89619 (chronic kidney disease [CKD] stages: 55.6% stage 1, 35.7% stage 2, and 8.8% stages 3-5). CVS rate increased from 91.90% at switch (from 90.46% 24 weeks before switch) to 95.57% and 97.21%at 48 and 96 weeks after (P = 0.03 and 0.02, respectively). Over the 96 weeks after switch, mean HBV DNA (P < 0.001) but not alanine aminotransferase or CKD stage decreased. Between switch and 96-week follow-up, 11% (26/235) of CKD stage 1 patients migrated to stage 2 and 8% (12/151) of stage 2 patients to stages 3-5, whereas 18% (27/151) from stage 2 to 1, and 19% (7/37) from stages 3-5 to 2. On multivariable generalized estimated equation analysis adjusted for age, sex, hypertension, diabetes, and cirrhosis, baseline eGFR, age (P < 0.001), and CKD stages 2 and 3-5 (vs 1) (both P < 0.001) were associated with lower follow-up eGFR. DISCUSSION: After an average of ± years on ETV, CVS increased from 91.9% at TAF switch to 97.2% at 96 weeks later. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Immunotherapy has dramatically improved the survival of patients with advanced or metastatic malignancies. Recent studies suggest thatimmunotherapy may increase the risk of hepatitis, whereas it may also induce functional cure of chronic hepatitis B virus (HBV) infection. We evaluated the incidence of hepatitis flare, HBV reactivation, hepatitis B surface antigen (HBsAg) seroclearance or seroreversion in patients with current or past HBV infection who had received immunotherapy. METHODS: This was a territory-wide observational cohort study in Hong Kong. We identified patients through electronic medical records based on the prescriptions of immune checkpoint inhibitors from July 1, 2014, to December 31, 2019. Patients who were HBsAg positive or HBsAg negative with results for antibody to hepatitis B surface or core antigen (anti-HBs or anti-HBc) were included. RESULTS: A total of 990 patients (397 HBsAg-positive, 593 HBsAg-negative with 482 anti-HBc and/or anti-HBs positive, and 111 both anti-HBc and anti-HBs negative) were identified. All of HBsAg-positive and 15.9% HBsAg-negative patients were put on oral antiviral treatment. Hepatitis flare (alanine aminotransferase >2 times of the upper limit of normal) occurred in 39.3%HBsAg-positive and 30.4% HBsAg-negative patients. High baseline alanine aminotransferase and combination of immunotherapy increased the risk of hepatitis. HBV reactivation (≥2 log increase in HBVDNA from baseline) occurred in 2 HBsAg-positive patients; HBsAg seroclearance and seroreversion was observed in 1 HBsAg-positive and 1 HBsAg-negative patient, respectively (<1%). DISCUSSION: Hepatitis flare occurs in approximately 40% of HBsAg-positive patients and 30% of HBsAg-negative patients during immunotherapy. HBV reactivation, HBsAg seroclearance, and HBsAg seroreversion are rare. Current or past HBV infection has no impact on the emergence of hepatic flare associated with immunotherapy. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of tenofovir alafenamide versus tenofovir disoproxil fumarate on antiviral efficacy in patients with hepatitis B virus infection. Methods: Randomized controlled trials were searched on CNKI, Wanfang, VIP, China Biomedical Literature Database, PubMed, Cochrane Library, Embase, ClinicalKey, Chinese Clinical Trial Registry and ClinicalTrials.gov from the date of inception to April 2020. The literature was screened according to the inclusion and exclusion criteria, and the efficacy evaluation index of the included RCT was set as the success rate of reaching the endpoint of viral suppression and achieving normalized ALT values at 48 weeks of treatment. Intentionality analysis was adopted and the analysis results were taken as the final conclusion. RevMan 5.3 software was used for this Meta-analysis. Meanwhile, VassarStats was used to evaluate the non-inferiority of TAF and calculate the difference of virus inhibition efficiency rate and 95% confidence interval between experimental group and the control group of each RCT. Results: After the literature search, 411 potential articles were found, 5 studies were finally included according to the criteria, and 2,120 patients were included. Intentionality analysis showed that TAF regimen and TDF regimen had similar viral suppression success rates (RR = 0.97, 95%CI: 0.94 ~ 1.01, P = 0.19). The ALT normalization rate in the TAF treatment group was higher than that in the TDF treatment group, and the difference was statistically significant (RR = 1.35, 95%CI: 1.20-1.53, P < 0.00001). The non-inferiority margin was set at 10%, and it was found that three RCT studies in the international multi-center all showed that TAF was not inferior to TDF in controlling HBV viral load, while two RCT studies in mainland China failed to achieve non-inferiority after calculation. Conclusions: At 48 weeks of treatment, TAF was similar to TDF in controlling HBV viral load. However, the efficacy of TAF in controlling HBV viral load may vary among different populations, which requires further confirmation by more clinical trial evidence. Based on AASLD criteria, the ALT normalization rate of the TAF group was higher than that of the TDF group at 48 weeks of treatment, showing an obvious advantage. [ABSTRACT FROM AUTHOR]

Infection with hepatitis B virus (HBV) remains an important public health problem with a high burden worldwide. The Saudi Association for the Study of Liver diseases and Transplantation formed a working group to develop HBV practice guidelines in Saudi Arabia. The methodology used to develop these guidelines was based on reviewing the available evidence, local data, and major international practice guidelines on the management of HBV. The aim of these guidelines is to assist healthcare providers in the management of HBV in Saudi Arabia. These updated guidelines summarize the latest local studies performed on HBV epidemiology, major changes in the prevalence of this virus, and advances in disease management. [ABSTRACT FROM AUTHOR]

The article highlights U.S. Food & Drug Administration's fast track designation for bepirovirsen due to the urgent need for hepatitis B treatments, supported by positive phase two trial results; promising new therapeutic with potential for HBV cure, awaiting phase three completion.

Chronic hepatitis B is a critical cause of many serious liver diseases such as hepatocellular carcinoma (HCC). The main challenges in hepatitis B treatment include the rebound of hepatitis B virus (HBV)-related antigen levels after drug withdrawal and the immunosuppression caused by the virus. Herein, we demonstrate that the HBV-related antigen can be effectively inhibited and antiviral immunity can be successfully reactivated through codelivery of the small interfering RNA (siRNA) targeting HBV X protein (HBx) and the plasmid encoding interleukin 12 (pIL-12) to hepatocytes and immune cells. After being treated by the siRNA/pIL-12 codelivery system, HBx mRNA and hepatitis B surface antigen (HBsAg) are dramatically reduced in HepG2.215 cells. More importantly, the downregulated CD47 and programmed death ligand 1 (PD-L1) and the upregulated interferon-β promoter stimulator-1 (IPS-1), retinoic acid-inducible gene-1 (RIG-1), CD80, and human leukocyte antigen-1 (HLA-1) in treated HepG2.215 cells indicate that the immunosuppression is reversed by the codelivery system. Furthermore, the codelivery system results in inhibition of extracellular regulated protein kinases (ERK) and phosphoinositide-3-kinase (PI3K)/protein kinase B (Akt) pathways, as well as downregulation of B-cell lymphoma-2 (Bcl-2) and upregulation of p53, implying its potential in preventing the progression of HBV-induced HCC. In addition, J774A.1 macrophages treated by the codelivery system were successfully differentiated into the M1 phenotype and expressed enhanced cytokines with anti-hepatitis B effects such as interleukin 6 (IL-6) and tumor necrosis factor-α (TNF-α). Therefore, we believe that codelivery of siRNA and pIL-12 can effectively inhibit hepatitis B virus, reverse virus-induced immunosuppression, reactivate antiviral immunity, and hinder the progression of HBV-induced hepatocellular carcinoma. This investigation provides a promising approach for the synergistic treatment of HBV infection.

Our objective was to examine differences in cytokine/chemokine response in chronic hepatitis B(CHB) patients to understand the immune mechanism of HBsAg loss (functional cure) during antiviral therapy. We used an unbiased machine learning strategy to unravel the immune pathways in CHB nucleo(t)side analogue-treated patients who achieved HBsAg loss with peg-interferon-α(peg-IFN-α) add-on or switch treatment in a randomised clinical trial. Cytokines/chemokines from plasma were compared between those with/without HBsAg loss, at baseline, before and after HBsAg loss. Peg-IFN-α treatment resulted in higher levels of IL-27, IL-12p70, IL-18, IL-13, IL-4, IL-22 and GM-CSF prior to HBsAg loss. Probabilistic network analysis of cytokines, chemokines and soluble factors suggested a dynamic dendritic cell driven NK and T cell immune response associated with HBsAg loss. Bayesian network analysis showed a dominant myeloid-driven type 1 inflammatory response with a MIG and I-TAC central module contributing to HBsAg loss in the add-on arm. In the switch arm, HBsAg loss was associated with a T cell activation module exemplified by high levels of CD40L suggesting T cell activation. Our findings show that more than one immune pathway to HBsAg loss was found with peg-IFN-α therapy; by myeloid-driven Type 1 response in one instance, and T cell activation in the other. [ABSTRACT FROM AUTHOR]

Dentists are at high risk for contracting Hepatitis B virus (HBV), which leads to severe liver disease. Proper infection control measures are supposed to be in place to avoid transmission, especially with the exposure to blood that dentists are at risk of. A cross-sectional study with quantitative method using a valid research questionnaire. A convenience sample of 101 dentists from around Lebanon participated in the study. The results showed that 83% of the participating dentists were vaccinated yet only 21% received the required dose for prevention against HBV. The dentists had moderate to high knowledge of HBV infection control measures, negative attitudes towards treating HBV exposed patients, as well as good practices of standard precautions. The results showed that there was a difference association between gender and vaccination (P=0.04). The results also showed that there was no remarkable association between years of experience and HBV infection prevention knowledge, however there was a significant association between gender, vaccination status and practices if infection control measures (P=0.00). The dentists report good KPA of infection control measures yet reinforcement is needed to ensure proper prevention of transmission of HBV in dental practice. [ABSTRACT FROM AUTHOR]

Purpose of Review: The World Health Organization has set a target for the elimination of hepatitis B virus (HBV) infection as a public health threat by 2030, but the U.S. is not currently on track. In this review, we describe specific barriers to HBV elimination, provide examples of potential solutions, and offer recommendations for how the U.S. can reach HBV elimination goals. Recent Findings: In the U.S., there are many barriers to eliminating hepatitis B, worsened by the siloing of healthcare and public health services. In recent years, we have not seen progress toward improving HBV screening or adult vaccination, and acute cases are on the rise. Current policies, guidelines, and recommendations can hinder elimination progress. Summary: Simple policy and guideline changes will allow us to decentralize and scale-up hepatitis B screening, vaccination, and care. Dismantling current barriers will be critical to eliminating hepatitis B in the U.S. [ABSTRACT FROM AUTHOR]

Objectives: The present study determined the prevalence of HBV/HCV coinfections; genetic diversity and drug resistance of HBV among HIV infected patients visiting Siaya County Referral Hospital, Kenya. Design: This was a hospital based cross-sectional study. Setting: This study was conducted at Siaya County Referral Hospital Laboratory and KEMRI HBV laboratory, Nairobi, Kenya. Subjects: A total of two hundred and twenty-five (225) HIV patients randomized from HIV comprehensive clinic of Siaya County Referral Hospital between August and December, 2018. Results: From the 225 samples that were analyzed, 6.2% (14/225) were HBV/HIV coinfected while that of HCV/HIV was 4.0% (9/225). However, no participant was coinfected with three viruses. Of the 11 samples that were successfully sequenced, the phylogenetic analysis revealed the sequences belonged to HBV genotype A1. Mutation rt169F was detected in one of the patient. Conclusion: From this study, HBV/HCV and HIV co-infections could be higher than reported here. HBV genotype A1 is the most predominant circulating genotype in Siaya County. All the detected HBV were susceptible viral strains with only one harboring HBV strain with rt169F mutation. There is therefore a need for a continuous surveillance of HBV/HCV/HIV co-infections, circulating HBV genotypes and drug resistant variants in this region in order to guide vaccine and optimization of treatment. [ABSTRACT FROM AUTHOR]

Résumé: Le paludisme a touché en 2019 environ 229 millions de personnes dans le monde et a entraîné plus de 400 000 décès dont 78 % sont des enfants de moins de cinq ans. En France, on dépiste chaque année 5 500 cas d'importation. Un vaccin a été approuvé en octobre 2021 par l'OMS qui qualifie sa mise au point comme une étape historique dans la lutte contre cette maladie. In 2019, malaria affected approximately 229 million people worldwide and caused more than 400,000 deaths, 78% of which were children under 5 years old. In France, 5,500 cases of importation are detected each year. A vaccine was approved in October 2021 by the WHO, which qualifies its development as a historic step in the fight against this disease. [ABSTRACT FROM AUTHOR]

Currently, liver transplantation (LT) is considered as the only option for the treatment of patients with various causes of liver failure, including patients with chronic hepatitis B virus (HBV) infections. Overall, patients with HBV who undergo LT are at increased risk of hepatitis B infection recurrence. Although the current knowledge regarding the pathophysiology of this infection has been dramatically increased over the past few decades, it is still considered a complex disease process with varying degrees of clinical characteristics and changing patterns over time. There are various treatment strategies for preventing HBV recurrence in the LT setting. Generally, these regimens include oral nucleoside/nucleotide analogues (NAs), hepatitis B immune globulin (HBIG), and vaccines or the combination of these drugs. The treatment strategy of choice should be based on cost-effectiveness, along with other patients underlying conditions. In this case, studies indicate that potent NAs are more cost-effective than HBIG in most case scenarios. In this article, we aimed to review the general medications used in the prophylaxis of the recurrence of HBV infection after LT. [ABSTRACT FROM AUTHOR]

Hepatitis B causes liver failure, cirrhosis and cancer. It has an estimated global prevalence of 6%, and 700,000 to 1 million persons die every year of hepatitis B-related causes. In 1989, hepatitis B incidence in Cuba was 14.9 per 100,000 population. To control infection, the Genetic Engineering and Biotechnology Center and the Ministry of Public Health, both in Havana, collaborated on a joint project that first produced natural interferon and recombinant interferon alpha-2b, and later a polyethylene glycol-conjugated interferon. As part of the Cuban biotechnology development strategy, the project produced a vaccine against hepatitis B in 1985. At that time, hepatitis B vaccines available elsewhere in the world were costly and inaccessible to Cubans due to the US economic and trade embargo. The Heberbiovac HB preventive vaccine was approved by the Cuban regulatory authority and added to the Cuban newborn vaccination program in 1992 after phase 1--3 clinical trials demonstrated its safety and immunogenicity. From 2001 to 2003, PAHO/WHO qualified and requalified the vaccine four times. When associated with other antigens or molecules, Heberbiovac HB provides a common platform of virus-like particles that can be used in different ways, such as in the pentavalent vaccine containing Bordetella pertussis and Haemophilus influenzae type b antigens and tetanus and diptheria toxoids. Thanks to this vaccine, annual incidence of acute hepatitis in Cuba has dropped from more than 2000 cases to fewer than 100, and no infections in children aged 0--15 years have been reported since 2007. It is now used in more than 30 countries, providing protective, long-lasting antibody levels with no reports of serious adverse events. Yet, hepatitis B cannot be eliminated until there are no chronic patients. The comprehensive hepatitis B control project therefore included development of a therapeutic vaccine based on Heberbiovac HB. Using its platform, researchers designed an innovative version of the vaccine that was the precursor of a therapeutic nasal/subcutaneous vaccine for chronic hepatitis B, HeberNasvac. This precursor vaccine, which combines Heberbiovac HB with a recombinant antigen from the virus nucleocapsid (rHBcAg), was patented and licensed in 2015 by the Cuban regulatory authority. This article provides an overview of the progress-to-date on the development of this therapeutic vaccine, including clinical trials (some completed and others ongoing) to determine safety, efficacy and therapeutic benefits. [ABSTRACT FROM AUTHOR]

Background The mechanisms underlying B-cell hyperactivation in patients with chronic hepatitis B virus (HBV) infection remain largely undefined. The present study assessed the clinical characteristics of the CD39/CD73/adenosine pathway in patients with chronic hepatitis B (CHB). Methods We examined CD39 and CD73 expression and adenosine production by B-cells from 202 HBV-infected patients. B-cell-activation phenotypes were assessed by flow cytometry after CpG+CD40 ligand stimulation with or without blockade and activation of the adenosine pathway. Results CD39 and CD73 expression on circulating B-cells was decreased in CHB patients with high HBV DNA, HBeAg positivity, high HBsAg levels, and active liver inflammation, and was hierarchically restored in complete responders according to HBeAg seroconversion or HBsAg reduction. However, CD39 and CD73 expression on activated memory and tissue-like memory B-cell subsets in complete responders was not increased despite effective antiviral treatments. Furthermore, CD39 and CD73 expression on intra-hepatic B-cells was decreased in inflammatory livers. In vitro , B-cells from CHB patients showed a markedly reduced capacity to generate CD39/CD73-dependent extracellular adenosine and expressed increased levels of activation markers after adenosine-production blockade. Contrastingly, metformin significantly reduced activation-marker expression via regulating AMP-activated protein kinase. Conclusions The skewed CD39 and CD73 expression on B-cells was associated with a high viral burden, liver inflammation, and antiviral efficacy in CHB patients, and the skewed CD39/CD73/adenosine pathway contributed to B-cell hyperactivation. Regulation of the CD39/CD73/adenosine pathway using metformin may represent a therapeutic option to reverse HBV-induced immune pathogenesis. [ABSTRACT FROM AUTHOR]

Hepatitis B virus (HBV) is a partially double-stranded DNA virus that specifically targets hepatocytes. It is considered a major health issue due to its high prevalence and the life-threatening consequences of chronic infection, including liver cirrhosis and hepatocellular carcinoma. Despite widespread vaccination against HBV, millions of people live with chronic HBV infection. Existing antiviral therapies fail to achieve full HBV elimination, so most patients with the disease require lifelong treatment. The search for new antiviral therapy strategies is hindered by the limited availability of in vitro HBV infection models that are able to support the full HBV life cycle. Therefore, the development and optimization of cellular models are crucial to the search for drugs effective against HBV. In this study, we optimized an in vitro HBV infection model consisting of two cell lines: HepAD38 cells, which are able to produce infectious HBV; and HepG2-NTCP cells, which are susceptible to HBV infection. We showed that prolonged production of HBV in the "donor" cells and HBV inoculation of the "acceptor" cells simultaneously with seeding improves the established procedure. This modified protocol was proven effective in experiments involving compounds with known activity against HBV, suggesting its utility for future high-throughput screening. [ABSTRACT FROM AUTHOR]

Background: Hepatocellular carcinoma (HCC) and liver decompensation are the serious complications of chronic hepatitis B (CHB) especially after development of cirrhosis. Current treatment of CHB is nucleos(t)ide analogues (NA). Objective: To evaluate the incidence and characteristic of HCC in patients with HBV cirrhosis as well as the rate of hepatic decompensation in NA treated CHB. Materials and Methods: A retrospective chart review of the patients with HBV associated cirrhosis who had attended Hepatitis Clinic, Siriraj Hospital between December 1, 2010 to December 31, 2011 was conducted. The hospital charts were reviewed to capture HBV related treatment, cirrhotic complication, occurrence, and characteristic of HCC. Results: There were 241 HBV related compensated cirrhosis enrolled in the study. Among these, 234 patients received NA treatment. There were 29 (12%) patients developed HCC during a median follow-up of 4.6 years and the incidence rates of HCC per 100 person- year was 2.6. There was no risk factor that predicted the occurrence of HCC, however, from multivariate analysis, older age, male gender, diabetes mellitus, HBeAg positive, alpha-fetoprotein (AFP) >10 IU/mL and HBV DNA >2,000 IU/ml at baseline trended to have a higher risk of HCC but did not reach statistical significance. Most HCCs found in the present study were asymptomatic and were found during surveillance and were single lesion located in the right lobe without portal involvement. Most of the HCC patients received potentially curative treatment (37.9%). Moreover, we found that the incidence of liver decompensation was 0.53 per 100 person-year. Two HCC patients died because of progressive liver disease. Conclusion: HCC is among the most serious complication of HBV related cirrhosis and occurred 2.6 per 100 person-year in the present study. It is unclear whether treatment would reduce HCC since most of the patients received treatment. Liver decompensation was found at 0.53 per 100 person-year which is lower than previous report. [ABSTRACT FROM AUTHOR]

Asian Americans Pacific Islanders (AAPI) share a disproportionate burden of chronic hepatitis B (CHB) in both the United States and New York State. Current hepatitis B virus (HBV) screening and research efforts have focused on urban communities. We administered a cross-sectional survey to 64 attendants at two free health fairs hosted by AAPI organizations on suburban Long Island, New York. We report the demographic make-up, healthcare attitudes, and HBV-related health histories of event attendees in Nassau and Suffolk Counties. Participants in Nassau County generally had more access to healthcare (97.1% vs 74.1% insured, 91.4% vs. 63.0% annual physician visit) and more familiarity with HBV screening (57.1% vs 17.2% history of HBV screening, 42.9% vs 3.9% physician recommendation for HBV screening). AAPI are a heterogenous population. Communities in close proximity may be demographically distinct and efforts to screen for HBV should be tailored to individual communities. [ABSTRACT FROM AUTHOR]

Background Universal vaccination for hepatitis B virus (HBV) and migratory movements have changed the demographic characteristics of this disease in Spain and in Europe. Therefore, we evaluated the characteristics of the disease and the possible differences according to origin (immigrants vs non-immigrants) and access to treatment. Methods This is a multicenter cross-sectional study (June 2014 to May 2015) in which outpatients with a positive HBsAg were seen and followed in four Hepatology units. Demographic and clinical data and indication and access to treatment were collected in two different regions of Catalonia (Spain) where there are no barriers to treatment due to a comprehensive coverage under the National Health System. Results A total of 951 patients were evaluated (48.1% men). Of these, 46.6% were immigrants (58.7% of them were born in Africa) and were significantly younger compared to non-immigrants. The proportions of patients with alcohol consumption, being overweight, and other indicators of metabolic co-morbidities were significantly higher in non-immigrants. Among the 937 patients receiving HBeAg examination, 91.7% were HBeAg-negative. Chronic HBeAg-positive infection was significantly higher in immigrants (3.9% vs 0.6%, P  =   0.001) and chronic HBeAg-negative hepatitis was higher non-immigrants (31.7% vs 21.4%, P  <   0.001). Not only was the proportion of patients who met treatment criteria significantly higher among non-immigrants (38.4% vs 29.2%, P  =   0.003), but also the proportion of those with indication of effectively receiving therapy at the time of data collection (83.2% vs 57.8 %, P  <   0.001). Conclusions The immigrant population with HBV is younger and has a lower prevalence of metabolic co-morbidities and a higher frequency of chronic HBeAg infection. Despite having access to care and an indication for treatment, some do not get adequately treated due to several factors including local adaptation that precludes access to treatment. [ABSTRACT FROM AUTHOR]